U.S. says HealthCare.gov enrollment appeal hearings to begin soon

WASHINGTON (Reuters) - The Obama administration on Monday
said it will soon begin hearings to resolve problems for people
who enrolled in health insurance through the Obamacare website
HealthCare.gov, only to encounter errors including unnecessarily
high costs.

The U.S. Centers for Medicare and Medicaid Services (CMS),
the lead agency responsible for implementing the healthcare
reform law, issued a statement saying it was reaching out to
consumers with error-ridden enrollments to help them complete
applications for coverage without a formal appeal.

The statement came in response to a Washington Post report
that said about 22,000 Americans have appealed to CMS for help
fixing enrollment mistakes that have led to excessive charges,
enrolled them in the wrong health plan or denied them coverage
altogether.

The appeals have hit a technological dead end, the newspaper
reported, because the administration has yet to complete the
technology infrastructure necessary to manage the appeals
process.

Obamacare's rocky implementation has already weathered
paralyzing glitches and a public outcry over insurance policy
cancellations for millions of people in the health plan market
for individuals.

"CMS is working to fully implement an automated appeals
system. Until we have that functionality, we are putting in
place a manual review process wherever possible and expect
hearings to begin soon," said the agency.

"In the meantime, CMS is reaching out to these consumers to
provide assistance so they can successfully complete their
application without the need to complete the appeals process."

CMS did not confirm the number of appeals reported by the
Post but said those filed are "largely related to earlier
technology problems that have since been fixed."

A CMS spokesman declined to say how soon hearings might
start. But analysts said a system would have to be in place
before March 31, the end of the Obamacare open enrollment period
for obtaining health coverage this year.

The Patient Protection and Affordable Care Act, President
Barack Obama's signature domestic policy achievement, is
intended to extend private health coverage to the uninsured by
selling private plans at subsidized rates through new
marketplaces. The law also calls on states to expand Medicaid
coverage for the poor.

HealthCare.gov, the Web portal for a federal marketplace
that spans 36 states, crashed soon after its October launch,
blocking access to some while saddling others with inaccurate
enrollment files. Four months later, CMS is still scrambling to
complete back-end systems that would allow the federal
marketplace to pay government subsidies to insurers on behalf of
low-income beneficiaries.

Republicans in Congress pounced on news of the appeals
problem as fresh evidence that the healthcare law's individual
mandate should be delayed. The mandate requires most Americans
to be enrolled in health coverage by March 31 or pay a penalty.

"Over four months after launch, the administration still
does not have its act together. They appear to be incapable of
addressing Obamacare's failures, unfairly leaving Americans on
the hook," said Joe Pitts, chairman of the House Energy and
Commerce health subcommittee.

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